Mypafootdoctor

Primary specialty

PodiatristTaxonomy code 213E00000X

License

SC006213 Issued in PA

Legal business name

MYPAFOOTDOCTOR

Doing business as

South Penn Foot, Ankle and Wound Care Specialists

Practice address

1055 Baltimore St Ste 1
Hanover, PA 17331-4400

Phone

(717) 524-1034

Fax

(833) 524-1034

NPI assigned

Apr 28, 2016

Last updated

Apr 30, 2023By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jim Maxka, DPMNPI 1932427762

Title

Sole Owner

Phone

(717) 524-1034

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• South Penn Foot, Ankle and Wound Care Specialists Doing business as

Medicare fee-for-service enrollment

Enrolled in PA2 enrollments

Enrollment records 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jim Maxka, DPM

  • Foot & Ankle Surgery Podiatrist
  • Hanover, PA
  • NPI 1932427762
  Medicare reassignment Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1461801600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682812800000",
    "number": "1538514492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1055 BALTIMORE ST STE 1",
            "city": "HANOVER",
            "state": "PA",
            "postal_code": "173314400",
            "telephone_number": "717-524-1034",
            "fax_number": "833-524-1034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1055 BALTIMORE ST STE 1",
            "city": "HANOVER",
            "state": "PA",
            "postal_code": "173314400",
            "telephone_number": "717-524-1034",
            "fax_number": "833-524-1034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MYPAFOOTDOCTOR",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-28",
        "last_updated": "2023-04-30",
        "certification_date": "2023-04-30",
        "status": "A",
        "authorized_official_last_name": "MAXKA",
        "authorized_official_first_name": "JIM",
        "authorized_official_title_or_position": "SOLE OWNER",
        "authorized_official_telephone_number": "717-524-1034",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "PA",
            "license": "SC006213",
            "primary": true
        },
        {
            "code": "261QP1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Podiatric",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103298961",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "South Penn Foot, Ankle and Wound Care Specialists",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Barry L Myers, DR OF CHIROPRACTIC
• Jennifer Clabaugh Myers, P.T. ASSISTANT
• Joyce M Myers, OPTICIAN
• Kasey Elizabeth Myers, MT-BC
• Myeyedr Optometry of Pennsylvania, LLC (MyEyeDr)
• Judith Ann Nagy, CRNP
• Natasha R Hewitt
• Natasha R Hewitt LLC
• National Vision Inc (America's Best Contacts & Eyeglasses)
• National Vision, Inc. (Vision Center brought to you by Wal-Mart)

• Podiatrist in Hanover, PA
• Providers in Hanover, PA by specialty
• Podiatrist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.